I have neglected updating this blog for a bit because I was hoping to have a better update with answers, advice and/or plan of action but I still don’t have it. Last I wrote, Dr. P (my follow-up surgeon) said the bones were healing well but was concerned about the painful popping I had along with my current pain levels. We agreed to continue with PT and see what was going on but a fall and increase in those symptoms looked like I was heading for more imaging.
Well when I met with Dr. P – he agreed that the increase was concerning. He didn’t think I did any real damage (to the bones & screws) but was worried about the labrum either not healing or tearing again. So I was sent off for another MRI or MR-arthrogram (with contrast dye). Dr. P also wanted me to have an inarticular steroid injection. He was hoping that it would help serve a diagnostic purpose (identifying it was actual joint pain) and offering some pain relief. I was worried about the screws but reassured that I wouldn’t have any discomfort with them and they were MRI safe but… they still don’t make it easy to see. What I also wasn’t prepared for was the changes in my hip – physiologically. As we get started with the injection – the radiologist is asking me about my surgery and current pain and proceeds to tell me about how with chronic pain and/or trauma the body reacts by increasing blood flow to the area. Well after so long… the body actually changes and grows more blood vessels and I have plenty – hypervascular. So hypervascular that he couldn’t get the dye to sit in the hip joint. Several pokes, repositioning and varied injection cocktails were needed to avoid overdosing me with the various meds that they were immediately being pulled away by my blood vessels. This also meant that I couldn’t have the steroid injection because it would not sit in the hip joint long enough to be effective. After he finally found a spot where only half the dye seemed to disappear, I was rushed in the MRI machine and after 20 minutes I was done and there was no more dye left in my joint – just a lot of pain. Another thing that was interesting was when he first turned on the fluoroscope he asked me if I had x-rays taken since my surgery. I said yes but was interested as to why he asked. He pointed to one of the osteotomy cuts and said it didn’t appear to be healed together. He immediately followed it by “well if your hasn’t mentioned it then it is probably just my angle.”
Well when I got the report back it was mentioned. The overall volume of bone callous at the puboacetabular junction was poorly seen and recommended a CT scan. He also said there was mild bone marrow edema in the femoral neck and over the bursa. I guess this could have something to do with the coxa valga and steep neck angles. He also reported a tear and fraying in the labrum and indicated that my CAM impingement was completely gone (go Dr. Mayo).
After meeting with Dr. P – he suggested that the labrum findings were inconclusive because of the extensive repair that was done during surgery – this kind of irritated me because I thought that was why we were doing the MR-A. He focused most on the puboacetabular junction and took another set of x-rays. He said it was hard to say definitively that the cut was healing together correctly. We discussed it at length. He said that it could explain the increased pain especially when sitting or weight bearing. Again I was frustrated because I have been complaining about this specifically for months. I understand that I am still not out of the realm of recovery where it would be completely atypical but I feel like I wasn’t listened to really.
So he suggested a CT scan. I asked what that would tell us… He said it would tell us if I had non-union or slow union. I asked what would that change for a “recovery plan” and he said he didn’t know if it would… What?!?! Then why? He said since he was consulting with Dr. Mayo and has never really seen non-union he wants to have the most information to present to Dr. Mayo to decide what to do. I get that but I am just frustrated that I don’t have any other answers. Tired of waiting for answers. Tired of having the same pain and not knowing why after doing everything my surgeons have said. Sigh. CT is scheduled for tomorrow. We will see how it goes…
PT had been going well and I feel like I am finally starting to gain some muscle back and my therapist feels I am doing great although she is still concerned about what is going on in the joint. I had a little setback with the pain flare from injection and some sicknesses but have an appointment tomorrow before the CT scan… and so it goes on. Hopefully my next update will be better.
4.5 months bilateral hips (note swelling on right side still)
Incision 4.5 months
Atrohpy & Rebuild at 4.5 months
Electrical Stim at PT
Therapy Pool at PT - AWESOME
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